Folic acid plays a vital role in ensuring the health of both mother and baby during pregnancy. This article will discuss the importance of taking folic acid while you are pregnant and the before becoming pregnant, helping you understand why it is important, the risks of low levels, and the advised dosages.
Folic Acid: An Essential Nutrient
Folic acid is a B vitamin that plays a crucial role in the production of red blood cells and the prevention of folate-deficiency anaemia. During pregnancy, it is particularly important because it helps form the neural tube in the baby, which develops into the brain and spinal cord.
Why Supplementation is Necessary
Folic acid supplementation is crucial for preventing neural tube defects (NTDs) like spina bifida and anencephaly. It also helps reduce the risk of low birth weight, anaemia, and iron deficiency. NTDs can develop within the first few weeks of pregnancy, often before a woman even knows she is pregnant, making supplementation all the more important.
The Consequences of Low Folic Acid Levels
Inadequate folic acid levels can increase the risk of NTDs in babies and folate deficiency anaemia in mothers. Inadequate levels can also influence pregnancy outcomes, such as contributing to low birth weight, which highlights the importance of supplementation.
Folate Rich Foods
Folic acid needs to come from a well balanced diet. Natural sources include leafy green vegetables, citrus fruits, and beans. Fortified foods, such as breakfast cereals, bread, and pasta, also contain folate. Aim to include these foods into your daily diet to help meet your daily needs without supplementation.
Folic Acid Tablets: Recommendations and Usage
Most women should take a daily dose of 400 mcg of folic acid, starting at least one month before conception and continuing through the first trimester of pregnancy. Women at an increased risk of NTDs, such as those with a family history or a previous NTD-affected pregnancy, may require a higher dose (4-5 mg) under the guidance of a healthcare professional.
L-methyl folate, the biologically active form of folate, can be used as an alternative to synthetic folic acid. It is more easily absorbed and used by the body. Consult your healthcare provider for personalised advice on whether L-methyl folate supplementation is appropriate for you.
Sri Lankan and International Recommendations
In Sri Lanka, a daily dose of 1 mg of folic acid is recommended during the preconception period and pregnancy, mainly due to the availability of 1 mg tablets. International guidelines from organisations such as the World Health Organization, Centers for Disease Control and Prevention, American College of Obstetricians and Gynecologists, and the UK’s National Health Service also provide valuable information on supplementation.
Folic acid is vital for the health of both mother and baby during pregnancy and the preconception period. By ensuring adequate intake, women can significantly reduce the risk of complications such as NTDs. It is critical to consult your doctor for personal advice on supplementation and to follow both local and international guidelines. Raising awareness about the importance of supplementation and promoting its use is crucial for improving mother and child health outcomes.
- NHS. Folic acid [Internet]. London: National Health Service; 2021 Mar 12 [cited 2023 Mar 27]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/#:~:text=Folic%20acid%20acts%20with%20vitamin,spina%20bifida%20in%20the%20baby.
- National Institute for Health and Care Excellence. Antenatal care for uncomplicated pregnancies. Clinical guideline [CG62]. London: NICE; 2008 Mar [cited 2023 Mar 27]. Available from: https://www.nice.org.uk/guidance/cg62.
- Royal College of Obstetricians and Gynaecologists. The importance of preconception care in the continuum of women’s healthcare. London: RCOG; 2018 Jan [cited 2023 Mar 27]. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_65.pdf.
- British Dietetic Association. Food Fact Sheet: Folic Acid [Internet]. Birmingham: BDA; 2021 Jun [cited 2023 Mar 27]. Available from: https://www.bda.uk.com/resource/folic-acid.html.
- Public Health England. Start4Life: Vitamins and supplements [Internet]. London: PHE; [cited 2023 Mar 27]. Available from: https://www.nhs.uk/start4life/pregnancy/vitamins-and-supplements-pregnancy/.
- Crider KS, Devine O, Hao L, Dowling NF, Li S, Molloy AM, et al. Folic acid supplementation during the preconception period. Br J Nutr [Internet]. 2014 Sep [cited 2023 Mar 27];112(5):777-85. Available from: https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/abs/folic-acid-supplementation-during-the-preconception-period/C8F874B7DC1F64E5915E37AD0A54F0F4.
- Akhtar S, Anjum FM, Anjum MA. Fortification of bread with folic acid: a review. Crit Rev Food Sci Nutr [Internet]. 2012 Feb [cited 2023 Mar 27];52(2):118-27. Available from: https://www.tandfonline.com/doi/abs/10.1080/10408398.2010.486802.